LA MEDICAL CLINIC INC (NPI# 1790242758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790242758 |
| Entity Type | Organization |
| Organization Name | LA MEDICAL CLINIC INC |
| Practice Address |
501 W Glenoaks Blvd Ste 200 Glendale CA 91202-4045 |
| Practice Telephone | 8186962156 |
| Practice Fax Number | 8183964448 |
| Mailing Telephone | 8186962156 |
| Mailing Fax Number | 8183964448 |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2019-02-26 |
| Authorized Official Name | LUSINE APIKYAN (PRESIDENT) |
| Authorized Official Telephone | 8186962156 |
| Authorized Official Credential | ANP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
501 W GLENOAKS BLVD STE 200 |
| City | GLENDALE |
| State | CA |
| Zip Code | 91202-4045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528538857 | Forever Active Cbas | Clinic/Center | 1111 W Glenoaks Blvd, Glendale, CA 91202 | 2018-11-29 |
| 1144724436 | Kristine Bustos | Nurse Practitioner | 1200 N Pacific Ave Ste 104, Glendale, CA 91202 | 2018-03-21 |
| 1295159614 | Kevin Lew | Dentist | 1122 N. Brand Blvd. Suite 102, Glendale, CA 91202 | 2014-02-05 |
| 1568709350 | Helen Chalakians | Counselor | 525 Glenwood Rd, Glendale, CA 91202 | 2013-01-14 |
| 1316216161 | Teresa Eligio | Nurse Practitioner | 857 Grant Ave, Glendale, CA 91202 | 2011-12-23 |
| 1033486139 | Advance Hospice Care, Inc. | Home Health | 1209 N. Central Ave Suite 204, Glendale, CA 91202 | 2011-11-18 |
| 1659518785 | Sarine Davityan | Marriage & Family Therapist | 1010 N Central Ave # 310, Glendale, CA 91202 | 2009-01-12 |
| 1760635619 | Tatiana Mikaelian Dds Inc | Dentist | 1209 N. Central Ave, #203, Glendale, CA 91202 | 2008-10-23 |
| 1669624219 | Marine Demirjian | Allergy & Immunology | 1131 N Pacific Ave, Glendale, CA 91202 | 2008-10-15 |
| 1902055783 | Lousine Vahagn Kirakosian | Dentist | 125 E. Glenoaks Blvd., Suite 103, Glendale, CA 91202 | 2008-09-16 |
| Find all providers in zip 91202 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003445768 | Anna Manukyan | Nurse Practitioner | 814 E Broadway Ste 1, Glendale, CA 91205-4552 | 2020-04-05 |
| 1689225427 | Robert Wayne Baker | Nurse Practitioner | 1236 E Harvard St, Glendale, CA 91205-1412 | 2019-09-23 |
| 1548785728 | Evette Facey | Nurse Practitioner | 6506 Myrtle Ave, Glendale, NY 11385-6250 | 2017-08-08 |
| 1619498128 | Anna Krakowski | Nurse Practitioner | 7137 70th St # C, Glendale, NY 11385-7245 | 2017-07-05 |
| 1023567435 | Victoria Bowers | Nurse Practitioner | 6808 N Dysart Rd Ste 136, Glendale, AZ 85307-2232 | 2016-09-26 |
| 1437474129 | Paula Kay Scoggins | Nurse Practitioner | 4221 W Villa Rita Dr, Glendale, AZ 85308-2514 | 2010-04-06 |
| 1205398120 | Christy L Hogue | Nurse Practitioner | 6677 W Thunderbird Rd Ste E, Glendale, AZ 85306-3722 | 2019-04-01 |
| 1518494020 | John Edgar Alan Hammonds | Nurse Practitioner | 5620 W Thunderbird Rd Ste F1, Glendale, AZ 85306-4652 | 2017-05-15 |
| 1750820478 | Mns Medical Group | Nurse Practitioner | 1110 Sonora Ave, Glendale, CA 91201-1952 | 2017-02-14 |
| 1558717314 | Jasmine Petrosyan | Nurse Practitioner | 519 E Broadway, Glendale, CA 91205-1110 | 2016-05-11 |
| Find all providers in GLENDALE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.